In the attached letter to Department of Health and Human Services (HHS) Secretary Sylvia Burwell, CHA emphasizes the ongoing geographic disparities in access to liver transplantation. The current liver allocation methodology, which is based on 58 local donation service areas (DSAs), puts Californians seeking livers at a significant disadvantage compared to patients in other parts of the nation. California transplants 27 liver patients per 100 patient years of waitlist time, though the national rate is 42 patients per 100 patient years. CHA believes that the current organ transplantation system, which arbitrarily favors certain zip codes and those with financial means, must be reformed to make the process more equitable. CHA calls on HHS to adopt the United Network for Organ Sharing’s policy recommendations, which would consolidate the 58 DSAs into four to eight sharing districts, with each district containing at least six liver transplant centers and a maximum median transplant-volume-weighted transport time between DSAs of no more than three hours.